Abstract

The position in which a woman births her baby is considered to be influenced by her social environment. The position adopted by a woman in labour has not only physiological stimuli but socio-cultural ones as well. Throughout the twentieth century women have been encouraged to remain in bed during labour and for the birth, which can be viewed as a position more convenient for the accoucheur, as this enabled easier access to undertake continuous fetal monitoring, intravenous therapy, vaginal examinations and to administer analgesia. A review of history however suggests today's birth postures were decreed and adopted on the basis of custom and convenience rather than physiological and anatomical indications and scientific data. There has been no study to examine the social context of women's choice of birth position or the influence of birth setting.

This study was undertaken to explore what concerns, principles and environmental factors guide women in their choices regarding birth positions. The study used qualitative methods of data collection and employed induction rather than deduction in the analysis. Clarification of these factors may influence the future provision of care by midwives, in addition to highlighting factors which may enhance maternal satisfaction. A grounded theory approach was utilised in this study by means of antenatal and postnatal interviews in two different hospital settings. Several factors that influenced women's choice of birth position were identified, some of which were interrelated. These included physicial and social environment, disciplinary power present in the medical system and related technology. The midwife and her support are also important factors affecting women's choice of birth position. A decision making typology that can be utilised by midwives to enhance their practice and assist women in their choice of birth position had been developed from this study.